Application of unidirectional barbed suture in transabdominal preperitoneal prosthetic

doi:10.3877/cma.j.issn.1674-0793.2017.06.014

Abstract

Abstract:

Objective

To investigate the safety and effectiveness of unidirectional barbed suture in transabdominal preperitoneal prosthetic (TAPP).

Methods

From April 2014 to April 2017, sixty-seven inguinal hernia patients were treated with TAPP in the Second Affiliated Hospital of Shantou University Medical College, with 32 undergoing inbarbed suture (inbarbed suture group), and the other 35 patients with traditional suture (traditional suture group). The suture time, operation time, intraoperative blood loss, hospital stay and complications of two groups were compared.

Results

All the 67 patients underwent operations successfully, with no one converting to open surgery and without perioperative complications. There were no statistical differences between the two groups in terms of preoperative general data, intraoperative blood loss, complications and hospital stay. The suture time and operation time of inbarbed suture group was (6.72±2.80) min and (63.00±5.44) min, which was significantly shorter than (15.04±1.19) min and (78.18±6.44) min of the traditional suture group, with statistically significant difference (t=10.372, 15.572, both P<0.01). All patients were under ultrasonic examination 1 to 3 months after discharging from hospital. No patient had recurrent inguinal hernia.

Conclusion

Unidirectional barbed suture can reduce the difficulty of laparoscopic suturing, and shorten the operation time and learning curve, which is worthy of clinical application in TAPP.

Key words: Laparoscopes, Hernia, inguinal, Sutures, Barbed suture

Guangrong Lin, Zhijie Xu, Weirong Chen, Gaoyang Cai, Peihong Zheng, Yanchong Li, Kaihuang Lin. Application of unidirectional barbed suture in transabdominal preperitoneal prosthetic[J]. Chinese Archives of General Surgery(Electronic Edition), 2017, 11(06): 418-421.

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References 15

[1]	鲁旭，吴立胜，刘玉海, 等. 经腹腹膜前腹腔镜疝修补术治疗腹股沟复发疝[J]. 中国微创外科杂志, 2014, 14(4):331-333.
[2]	Takata MC, Duh QY．Laparoscopic inguinal hernia repair[J]. Surg Clin North Am, 2008, 88(1):157-178．
[3]	陈鑫，李建文. 从循证医学角度谈腹腔镜腹股沟疝修补术疝修补术20年进展[J]. 中国实用外科杂志, 2014, 34(5):391-395.
[4]	朱玉，平洪，王明考, 等.经腹腹膜前3D腹腔镜腹股沟48例诊治分析[J/CD]. 中华普通外科学文献（电子版）, 2017, 11(2):132-133.
[5]	Gzen AS, Arslan M, Schulze M, et al. Comparison of laparoscopic closure of the bladder with barbed polyglyconate versus polyglactin suture material in the pig bladder model: an experimental in vitro study[J]. J Endourol, 2012, 26(6):732-736.
[6]	廖梓群，陈维荣，陈喜贵, 等. 倒刺缝线在腹腔镜胃十二指肠溃疡穿孔修补术中的应用[J/CD]. 中华普外科手术学杂志(电子版), 2017, 11(1):46-48.
[7]	Yokoyama K, Tanigawa N, Ogata A, et al. Laparoscopic technique and initial experience of choledocholithotomy closure with knotless unidirectional barbed sutures after surgery for biliary stone disease[J]. Surg Laparosc Endosc Percutan Tech, 2015, 25(4):e129-e133.
[8]	段键，夏仁品，林杰, 等. 单向倒刺线在腹腔镜肝叶切除联合术中胆道探查中的运用[J].中国普通外科杂志, 2016, 25(2):186-190．
[9]	金凤斌，任波，陈双, 等. Quill缝线在腹腔镜下子宫肌瘤剔除术中的应用效果[J]. 中国微创外科杂志, 2016, 22(1):24-27．
[10]	陈孝平，汪建平，秦新裕, 等. 外科学[M]. 8版, 北京: 人民卫生出版社, 2013.
[11]	林启谋，李勇，周毅, 等. 腹腔镜完全腹膜外腹股沟疝修补术后睾丸动脉血流灌注的影响因素分析[J/CD]. 中华普通外科学文献(电子版), 2017, 11(2):100-103.
[12]	Tolver MA, Strandfelt P, Rosenberg J, et al. Pain characteristics after laparoscopic inguinal hernia repair[J]. Surg Endosc, 2011, 25(12):3859-3864.
[13]	赵玉沛，姜洪池. 普通外科学[M]. 北京: 人民卫生出版社, 2008．
[14]	Tyner RP, Clifton GT, Fenton SJ. Hand-sewn gastrojejunostomy using knotless unidirectional barbed absorbable suture during laparoscopic gastric bypass[J]. Surg Endosc, 2013, 27(4):1360-1366.
[15]	Segura-Sampedro JJ, Ashrafian H, Navarro-Sanchez A, et al. Small bowel obstruction due to laparoscopic barbed sutures: an unknown complication?[J]. Rev Esp Enferm Dig, 2015, 107(11):677-680.

组别	例数	年龄（岁，±s）	疝类型（例）		疝囊直径（cm，±s）	疝囊位置（例）
组别	例数	年龄（岁，±s）	直疝	斜疝	疝囊直径（cm，±s）	左侧	右侧
倒刺线组	32	55.0±3.2	7	25	4.3±0.6	17	15
传统缝线组	35	54.7±2.9	9	26	4.1±0.8	18	17
统计值		t=0.403	χ²=0.136		t=1.149	χ²=0.019
P值		0.067	0.713		0.194	0.890

组别	例数	年龄（岁，±s）	疝类型（例）		疝囊直径（cm，±s）	疝囊位置（例）
组别	例数	年龄（岁，±s）	直疝	斜疝	疝囊直径（cm，±s）	左侧	右侧
倒刺线组	32	55.0±3.2	7	25	4.3±0.6	17	15
传统缝线组	35	54.7±2.9	9	26	4.1±0.8	18	17
统计值		t=0.403	χ²=0.136		t=1.149	χ²=0.019
P值		0.067	0.713		0.194	0.890

组别	例数	手术时间（min, ±s）	缝合时间（min, ±s）	术中出血（ml, ±s）	术后并发症[例（%）]	术后住院时间（d, ±s）
倒刺线组	32	63.00±5.44	6.72±2.80	12.64±1.20	3(9.38)	4.59±0.81
传统缝线组	35	78.18±6.44	15.04±1.19	13.46±1.16	4(11.43)	4.44±0.80
统计值		t=10.375	t=15.572	t=2.843	χ²=0.016	t=0.762
P值		<0.01	<0.01	<0.01	0.900	0.627

组别	例数	手术时间（min, ±s）	缝合时间（min, ±s）	术中出血（ml, ±s）	术后并发症[例（%）]	术后住院时间（d, ±s）
倒刺线组	32	63.00±5.44	6.72±2.80	12.64±1.20	3(9.38)	4.59±0.81
传统缝线组	35	78.18±6.44	15.04±1.19	13.46±1.16	4(11.43)	4.44±0.80
统计值		t=10.375	t=15.572	t=2.843	χ²=0.016	t=0.762
P值		<0.01	<0.01	<0.01	0.900	0.627

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